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Issue: Issue 5 (2018) – Supplement 1


How old are you? Clinical outcome of mechanical thrombectomy in the elderly patients with acute ischaemic stroke

M.A. Correia, F. Raposo, J.B. Madureira, M. Mendonça, C. Guerreiro, F. Proença, P. Teotónio, L. Biscoito, P. Sequeira, and L. Neto
Background: Mechanical thrombectomy (MT) has proven to be an effective treatment for proximal occlusions of the major intracranial arteries in stroke patients, but there is only limited information as to whether there should be an age limit for its use. With the average life expectancy increasing worldwide, usually surpassing 80 years old, it remains uncertain whether MT is effective in this group of patients.
Objective: To evaluate the safety and efficacy of endovascular therapy in elderly adults treated for acute ischaemic stroke.
Methods: We retrospectively collected all the patients with >80 years old subjected to MT in our centre during 2016-17. We analysed success of recanalization (Thrombolysis In Cerebral lnfarction (TICI) >2b), neurological improvement (improvement of ?4 points on National Institutes of Health Stroke Scale (NIHSS)), favourable and moderate clinical outcome (modified Rankin Scale (mRS) score at 3 months ?2 and =3, respectively) and mortality.
Results: From a total of 220 patients that underwent MT in our centre, we selected 57 patients with 84 ± 3.4 years old. The mean NIHSS on presentation was 17.8±5.52 and 11.4±7.6 post thrombectomy, with neurological improvement present in 65.5%. The success of recanalization was reached in 78.9% of the patients, favourable clinical outcome was achieved in 33.3% and moderate outcome in 24.6%. The mortality rate was 10.5%.
Conclusions: Clinical independence was reached in a significant number of patients, and an additional important group was able to walk without assistance. This total of 57.9% shows that, even if associated with higher morbidity and mortality, MT is a treatment option very viable when quality of life is the most important consideration for acute ischemic stroke in elderly patients.

From the Lisbon Stroke Summit, Lisbon, Portugal. 6–7 April 2018.

International Journal of Clinical Neurosciences and Mental Health 2018; 5(Suppl. 1):P23
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